关键词: 肠套叠, 右美托咪定, 水压灌肠复位

Abstract:

Objective  To evaluate the safety and efficacy of  intranasal administration of dexmedetomidine in the ultrasound-guided hydraulic enema reduction in children with intussusception.

Methods  In total, 100 children with intussusception who underwent the ultrasound-guided hydraulic enema reduction in Kunming Children′s Hospital were selected as the research subjects. The patients were randomly divided into two groups: experimental group(group A, intranasal administration of 2 μg/kg dexmedetomidine) and control group(group B, with an equal amount of saline). Heart rate(HR), mean arterial pressure(MAP) and pulse oxygen saturation(SpO2) were recorded at the time of entering the room( T0), at 30 min after nasal drip(T1), at one-time enema reduction of anal canal(T2), immediately after successful reduction(T3) and at the time of leaving the room after recovery(T4). The success rate and reduction time of different pressures, hospitalization expenses and related complications after sedation were recorded.

Results  HR and MAP decreased initially and then increased in group A, and increased initially and then decreased in group B. There were significant differences in interaction between two groups, different time points and time points between groups(P＜0.05). SpO2 in the two groups increased initially and then decreased. There was no significant difference in the interaction between groups and time points between groups(P＞0.05), and there was significant difference between different time points(P＜0.05). The success rate of group A at the reset pressure of 11.1 -13 kPa was higher than that of group B(P＜0.05), and there was no significant difference between two groups at the reset pressure of 13.1-15 kPa(P＞0.05). There was no significant difference in the incidence of reflux, aspiration, respiratory depression and laryngeal spasm between two groups(P＞0.05). The satisfaction of family members in group A was higher than that in group B(P＜0.05). The reduction time and hospitalization expenses in group A were less than those in group B(P＜0.05).

Conclusion  Intranasal administration of  2 μg/kg dexmedetomidine can be safely used in  the ultrasound-guided hydraulic enema reduction in children with intussusception, which can not only improve the success rate of reduction, but also reduce the hospitalization expenses, with high satisfaction of children′s families.

Key words: intussusception; dexmedetomidine, hydraulic enema reduction